Current Management of Enterocutaneous Fistula

Evenson, Amy; Fischer, Josef E.

doi:10.1016/j.gassur.2005.08.001

Cited by 189 publications

(267 citation statements)

References 28 publications

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“…All of these factors contribute to the morbidity, mortality, and likelihood of spontaneous closure [11].…”

Section: Classificationmentioning

confidence: 99%

“…A wellorganized management strategy utilizing of a multidisciplinary team approach is essential. A remarkable amount of time and labor along with intensive resource utilization yields closure rates ranging from 5 to 20 % without surgical intervention and 75-85 % with definitive operative treatment [2,3 • , 4, 5 [7][8][9][10][11]. The team members involved in the care of these complex patients include: general and reconstructive surgeons, nutritional support staff, bedside and enterostomal nursing, social workers, radiologists, internists, psychiatrists and physical therapists, among others [1].…”

Section: Introductionmentioning

confidence: 99%

“…Strict adherence to the following principles of management is paramount: (1) identification of the fistula; (2) resuscitation and sepsis control with correction of electrolyte imbalances; (3) protection of the skin and control of fistula output; (4) nutritional support; (5) radiographic investigation; and (6) definitive management, potentially with operative repair [11]. Long-term morbidity and mortality are associated with recurring sepsis, failed operative closure with recurrent ECF, short bowel syndrome, and cholestatic liver failure.…”

Section: Introductionmentioning

confidence: 99%

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Enterocutaneous Fistulas: A Look at Causes and Management

2014

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Despite advances in medical technology and surgical care, the management of enterocutaneous fistulas remains one of the most challenging problems faced by physicians. Success depends on an expert multidisciplinary team, access to long-term enteral and parenteral nutrition support, advanced wound care, optimal medical management and meticulous, methodical, surgical decision-making and technique. Management is complex and multiphasic. Improved survival rates for many morbid problems have resulted in a growing population of patients with increasingly complex fistulas. This article reviews the etiologies as well as classic and evolving management strategies for this problem.

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“…All of these factors contribute to the morbidity, mortality, and likelihood of spontaneous closure [11].…”

Section: Classificationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Enterocutaneous Fistulas: A Look at Causes and Management

2014

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“…(9) El tratamiento quirúrgico estará indicado solo en situaciones particulares, el tratamiento inicial debe ser conservador. (3)(4) En1964 Chapmann cambio manejo de los pacientes y propuso 4 principios de manejo.…”

Section: Fisiológicounclassified

Postoperative enterolaparotomica fistula Presentation of case report and review of literature

Delgado¹,

Gómez²,

Fernández³

et al. 2016

Rev. Cir. Parag

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RESUMENSe define a la fístula como una comunicación anormal entre dos superficies epitelizadas. Se presenta como una complicación postoperatoria, con una morbimortalidad elevada. Se clasifica según su etiología, topología y fisiología. En 1964 Chapmann propuso 4 principios de manejo divididos en etapas. Se presenta el caso de un paciente de sexo masculino de 43 años con antecedente de traumatismo penetrante de abdomen por proyectil de arma de fuego hace 1 año. Acude al Servicio 1 año después por cuadro de secreción intestinal por cicatriz quirúrgica, con debito mayor a 500cc por día. Es diagnosticado con una fistula enterolaparotómi-ca (FEL) de alto débito. Recibe tratamiento médico conservador por 4 a 6 semanas y posteriormente se decide conducta quirúrgi-ca. Se realiza laparotomía, liberación de adherencias, sutura intestinal e ileostomía. Paciente con buena evolución post operatoria es dado de alta en su décimo día post operatorio.Palabras Claves: Fistulas enterocutáneas, tratamiento conservador, tratamiento quirúrgico. SUMMARYA fistula is defined as an abnormal communication between two epithelialized surfaces. It is presented as a postoperathoria, complicacion with a elevated morbidity and mortality. It is classified according to it is etiologicalogy, topology and physiology. In 1964 Chapmann proposed four principles of management, divided into stages. We presents the case of 43 years old male patient with a history of penetrating abdominal trauma by firearm projectile one year ago. Now he come of our surgery service because he was present an intestinal secretion by surgical scar, with a 500cc per day. He it is diagnosed with enterocutaneous fistula (ECF) of high-output. He is received Conservative medical treatment for four to six weeks and later surgical treatment will be decided. Laparotomy, release of adhesions, intestinal suture and ileostomy is performed. The patient present a good postoperative evolution and he was become out of ten day after surgery.Keywords: Fistulas in-terocutáneas, conservative treatment, surgical treatment. Fistula enterolaparotómica post-operatoria presentación de caso clínico y revisión de literatura INTRODUCCIÓNSe define a la fístula como una comunicación anormal entre dos superficies epitelizadas, es decir entre dos órganos huecos o bien entre un órgano hueco y la piel.(1)El cuadro clínico habitual se caracteriza por fiebre de un paciente operado, con una herida eritematosa. Tras retirar algunas suturas cutáneas se observa una secreción de contenido intestinal sucede bien inmediatamente o al cabo de 1 o de 2 días. Si se duda del diagnóstico se puede confirmar administrando un marcador no absorbible por vía oral, como carbón o rojo Congo, o inyectando un medio de contraste hidrosoluble en la fistula.(5)

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“…EAF is often associated with fluid-electrolyte disturbances, nutritional deficiency, and life-threatening sepsis (4).…”

Section: Introductionmentioning

confidence: 99%

Management of Enteroatmospheric Fistulae Developing Post Sitoreductive Surgery

Ulukent¹,

Erdem²,

Seyhan³

et al. 2016

JAREM

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If an open abdominal patient develops enteric fistulae, the condition will be defined as enteroatmospheric fistulae (EAF). As it is not covered with tissue and does not have a fistula tract, it cannot be considered a real fistula. In total, 25% of open abdominal patients develop EAF and have a mortality rate of approximately 42%-75%. In this article, we present the case of a patient with EAF developing post sitoreductive surgery. As the recovery time of grade 4 open abdominal patients can be 6 months or longer, it was our aim to convert the fistula mouth to a stoma. (JAREM 2016; 6: 122-5)

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Current Management of Enterocutaneous Fistula

Cited by 189 publications

References 28 publications

Enterocutaneous Fistulas: A Look at Causes and Management

Enterocutaneous Fistulas: A Look at Causes and Management

Postoperative enterolaparotomica fistula Presentation of case report and review of literature

Management of Enteroatmospheric Fistulae Developing Post Sitoreductive Surgery

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